Transcaval Migration of an Acupuncture Needle from the Abdominal Cavity to the Heart

Abstract

We report the case of a patient who was noted to have inserted an acupuncture needle into his abdomen. The needle migrated to the heart and was removed from the right ventricle using cardiopulmonary bypass.

The story of the lost needle: Foreign body embolization to the heart

“…To our knowledge this is the first reported case in which a needle lost during abdominal wall surgery was later found and recovered within the heart chambers. Along with previous reports of bullets, sewing needles, acupuncture needles, welded metal, and orthopedic hardware migrating through the venous circulation to the heart [3,5,7], this case illustrates that such a mechanism is possible and might be considered in the management of foreign bodies in the abdomen and the liver.…”

“…The sharp tip of the needle was projecting through the interventricular septum into the mitral valve and led to severe damage to the valvular apparatus. Similar migration of an acupuncture needle from the abdomen to the heart has been reported in the past [7]. An alternative path particularly for a sharp needle would be by direct penetration from the liver through the diaphragm and into the heart.…”

Foreign Bodies in the Heart

“…Some sharp objects, such as needles and tattoo needles may penetrate the human body. 42,[66][67][68][69][70][71][72][73][74] These require surgical removal.…”

An Acupuncture Needle Remaining in a Lung for 17 years: Case Study and Review

“…Acupuncture needles have been reported in bladder, 2 11 nuchal and occipital area, 4 shoulder girdle, 12 spinal cord, 3 13 right atrium, 25 right ventricle, 14 15 L5 nerve root, 16 medulla oblongata, 17 18 skin, 19 carpal tunnel, 20 calf 21 and paraspinal muscle.…”

“…Neely et al described a needle migrating from the abdominal cavity to the right atrium, which was removed through open-heart surgery, with the patient's uneventful postoperative recovery. 25 In other cases removal of a needle has also led to full recovery. 3 5 20 23 An interesting method of needle removal was described by Sakai et al 22 They used the 'neuronavigator' system consisting of a six-joint sensing arm and a personal computer to mark the shortest point from the skin to the needle on the skin surface.…”